Robin Irvin Glass, DC, DACNB
Individual provider Active NPI Neurology Chiropractor · Bloomfield, NM
NPI 1760569990 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1760569990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Chiropractor 111NN0400X
- License
- 782 (NM)
- Practice address
- 308 N 1St St
Bloomfield, NM 87413-5305 - Phone
- (505) 634-0714
- Fax
- (505) 632-1111
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1982
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
308 N 1St St
Bloomfield, NM 87413-5305
Phone (505) 632-1111
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110127001046 | NM | Practitioner - Chiropractic | 6305025958 |
Reassigns benefits to 1 organization Practice locations: Bloomfield, NM; Santa Fe, NM |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 782 | NM | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern New Mexico Health Care, LLC | Current |
Accepting new patients | |
| Age to Age Counseling PC | Past |
Accepting new patients | |
| Bloomfield Chiropractor Center Inc | Past | Accepting new patients |
Locations
1421 Luisa St
Ste R
Santa Fe, NM 87505
Phone (505) 470-6119
2019 Galisteo St
Ste H2
Santa Fe, NM 87505
Phone (505) 291-6314
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 782 | NM | Yes |
Addresses
Primary practice location
308 N 1St St
Bloomfield, NM 87413-5305
Mailing address
324 N Valley Blvd
Bloomfield, NM 87413-5620
Phone (505) 634-0714
Other providers in Bloomfield, NM
- Jo Beth Fritz
- Michelle Gabaldon
- Aimee M Garrett
- Selece Gathings
- Amber Giles
- Andrea Gonzales
- James B Guynn
- William R Hall
- Lisa Hamilton
- Bryan Wayne Harber
All providers in Bloomfield, NM · Neurology Chiropractor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.